Taking action on Zika

The outbreak of Zika virus in the Americas and possible link to microcephaly has caused international concern, with the WHO declaring a Public Health Emergency of International Concern. Our Zika virus explainer outlined what we know about the virus, and where gaps in our understanding lie. In this blog post we look at different research programmes the Wellcome Trust is involved in which may help to bring the outbreak under control.

GSK Brazil Employee during medicine production on Flickr

Understanding the health consequences of microcephaly

Since October there have been approximately 4,000 babies born in Brazil with abnormally small heads – a condition called microcephaly. While a definitive link is not yet proven, the evidence is growing that the increase in reported cases of microcephaly is being caused by mothers contracting the Zika virus at some stage during pregnancy.

Work funded by the Brazilian government is already underway to try to figure out how Zika may be causing these birth abnormalities and at what stage of pregnancy women are most vulnerable. As part of this work, the Wellcome Trust has funded Professor Laura Rodrigues from the London School of Hygiene and Tropical medicine to follow a cohort of newborn babies to see how they develop during the first two years of life. They will carry out assessments of development, brain scans and other measures to try and build a picture of how this newly identified type of microcephaly affects the health of the children as they grow up, for example through potential learning difficulties.

The outcomes of the research will help the Brazilian Ministry of Health, health providers in Brazil and other Zika-affected countries to understand the true burden of microcephaly and develop appropriate support services for children with the condition. The work may lead to preventative strategies to protect pregnant women in future.

Controlling the mosquitoes that spread the virus

Mosquito larvae of two different Culicine species. Culex on the left and aedes on the right. Credit: LSHTM

Without a vaccine or treatment for Zika on the immediate horizon, one of the most promising options for controlling the spread of the virus in the medium term is by curtailing the Aedes mosquito that transmits the virus. The Aedes mosquito is exquisitely adapted to urban living and is notoriously difficult to control, however there are a number of innovative approaches in development that could have an impact.

We are in active discussion with research teams, partner funders and the governments of the region to assess whether the following interventions could have a role in bringing the epidemic under control:

An Eliminate Dengue illustration of the Aedes mostquito infected with wolbachia.

A biotech firm called Oxitec, which the Wellcome Trust funded for several years, has developed a genetically modified version of the male Aedes aegypti mosquito, which produces sterile offspring. Field trials have shown that controlled release of these mosquitoes into to a specified area can dramatically reduce or even eliminate the mosquito population, thereforeremoving the vector that carries harmful viruses.

We have funded another mosquito control programme called Eliminate Dengue, which uses naturally occurring bacteria called wolbachia to curb the spread of infection. Wolbachia prevents the dengue virus from growing properly inside the insect meaning it cannot be passed between people. As the mosquitoes breed, they pass on the bacteria through their eggs so that it soon spreads throughout the population.Field trials of the wolbachia mosquitoes began in Australia in 2011 and have now been carried out in four other countries, including in Brazil. Experts are hopeful that wolbachia may help curb the spread of the Zika virus, though further research is needed to test this theory and to determine the best way to deploy wolbachia across entire cities.

We also recently funded Professor Luke Alphey from the Pirbright Institute to investigate other methods for controlling the spread of viral infections by mosquitos, using synthetic biology techniques, though these are not yet in field trials.

Senior Research Fellow Professor Simon Hay and colleagues at the Wellcome Trust Centre for Human Genetics recently published new maps detailing the global distribution of the Aedes mosquitoes. It shows that the geographical spread of Aedes is now the widest it’s ever been, with the mosquitoes present in all continents including North America and parts of Europe. This information will help to determine the areas that may be affected by Zika if the virus continues to spread.

As with Ebola, Zika virus has demonstrated our vulnerability to emerging infectious diseases with the potential to cause pandemics. We have contributed to several high profile reports published in the wake of Ebola that have outlined the important changes to global health systems to address these gaps.

The Wellcome Trust was a co-sponsor of the report, and is advocating several important reforms of global health systems, including:

Establishing a permanent, independent WHO body with the authority and agility to coordinate the global response to infectious disease outbreaks.

Efforts to fully integrate research and development into the 21st century emergency response, for example by conducting safety testing of promising drugs and treatments and agreeing clinical trial protocols in advance of an outbreak.

Strengthening the public health systems and research infrastructure as the first line of defence against potential pandemics, particularly within low and middle-income countries.

We are very involved with many partners around the world to ensure that the response and the critical research work are very clearly coordinated. We have not opened an emergency funding call for Zika proposals, as we did with Ebola, but we will be watching the development of the epidemic as it progresses, working very closely with our partners and will keep this under constant review.

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Wellcome Trust

The Wellcome Trust is a global charitable foundation dedicated to improving health by supporting bright minds in science, the humanities and social sciences, and public engagement. Read more.

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